A "significant improvement" is needed in the way hospitals deliver care to people with dementia, according to a new report.

While hospitals say they have policies in place, these are not always followed and simple steps are not taken that could lessen the distress to patients, most of whom are elderly.

The study said the encounter between staff and patients "is mainly task-related and delivered in a largely impersonal manner" while the hospital environment is "often impersonal".

Staff do not always greet or talk to patients during care, explaining what they were doing or offering choice. Sometimes they do not respond to patient requests for help.

The National Audit of Dementia, which covers England and Wales, found only 6% of people with dementia had their level of cognitive impairment measured on admission and discharge, while only 43% of case notes showed patients had a mental status test despite 75% of hospitals saying they had a procedure for it.

Only 9% of case notes showed patients being screened for delirium, despite 33% of hospitals saying they had policies in place.

People with dementia can become agitated, distressed or aggressive while in hospital due to the environment, aspects of care, illness or injury, or their dementia getting worse.

NHS guidance says the use of antipsychotics to control these symptoms should be a last resort, but many hospitals still use them. The audit found 28% of people with dementia received antipsychotic medication in the hospital, of which 12% were newly-prescribed the drugs after admittance.

The reasons for these prescriptions were not recorded in 18% of these cases while less than half of staff felt properly trained in dealing with challenging behaviour.

More than half (59%) of wards said personal items - such as family photographs or cards - were not put where dementia patients could see them for reassurance.